MOUNTAIN VIEW (CBS 5) — Nursing homes are supposed to be safe havens for the elderly and the disabled. But a growing number are giving some residents the boot.

It usually happens at a most vulnerable time, when the resident has to go to the emergency room. Some are calling it the “hospital dump.”

It happened to Patricia Jimno in May, when she got an infection after knee replacement surgery.

The nursing home she was recovering in, Grant Cuesta Sub-Acute Rehab Center in Mountain View sent her to El Camino Hospital for emergency treatment.

But a few days later when the hospital was ready to discharge her, she said the rehab center told her they couldn’t take her back. Jimno said they told her friend, “We no longer want her things here, they are going to be put out on the street. I was a bit confused because I didn’t do anything.”

Jimno had a right to be confused. California law states nursing homes have to save a bed for seven days if a resident needs to go to the hospital. And Jimno was ready to come back well within that time. At a state hearing, a judge even ruled the nursing home had to readmit her. But she still wasn’t allowed back in.

“It’s probably been the number one area of concern,” says Tony Chicotel, an attorney with California Advocates for Nursing Home Reform.

Chicotel said nursing home evictions are getting more common, especially for patients on Medi-Cal, which has the lowest re-imbursement rate.

“There’s roughly 75 to 90 hearings per year. My guess is for every one hearing there’s at least ten, maybe twenty, thirty residents who are essentially dumped,” Chicotel said.

He said nursing homes routinely ignore the law and the state isn’t doing anything about it.

Part of the problem according to Chicotel: Patients are tossed between two separate agencies, ironically working out of the same building in Sacramento, with neither taking full responsibility.

“The Department of Health Care Services conducts the fair hearings. And they say well were not really involved in enforcement,” said Chicotel. “But the Department of Public Health which is charged with enforcing nursing homes laws says well we’re not really a party to the fair hearing so were not bound by them.”

“It reminds me of the Wizard of Oz and the scarecrow where the fingers are pointing in both directions,” said Marianne Cunningham. Her mother Hazel Walsh lived in Golden Gate Health Center in San Francisco for seven years. But suddenly last winter after a brief hospital visit that nursing home too told her she couldn’t come back.

“What surprised me more was that there were beds available in the facility,” she said.

The family followed protocol and appealed. At a hearing a judge ruled in her mother’s favor.

“I was ecstatic. I thought we were finally on our way,” Cunningham said. But then nothing happened. Nine months later Walsh still doesn’t have her bed back.

“The agency responsible to protect the health and safety of our most vulnerable citizens in this state like my mom, turned their back on them,” said Cunningham.

CBS 5 took their concerns to Al Lundeen at the Department of Public Health. When asked why the judge’s ruling was ignored, he said, “Ultimately if they are not abiding by the law we have the ability to issue citations,”

But according to the state’s own data, citations are uncommon. From 2002-2008, there were 218 hearings regarding nursing home evictions. Residents won 147 of them. But the Department of Public Health issued only 40 citations.

Lundeen insists his Department is doing everything it can under the law.

So what happened in the Walsh and Jimno cases? Walsh’s nursing home got cited and fined a total of $700. Marianne’s mother was eventually pushed out of the hospital she was in, to a nursing home far away from her family in Hayward.

“She lost friends of 50 years that she would see on a regular basis. Anything possible that made her happy was taken away in one fell swoop,” Cunningham said.

As for Jimno, after 3 months her case is still under investigation, while she lies in the hospital waiting. “I just don’t understand how they could do that to me,” she said.

Jimno’s rehab center told CBS 5 they can’t comment on the case for privacy reasons. Walsh’s nursing home said they held a bed in compliance with state regulations but the family turned it down, which the family denies.

(Copyright 2011 by CBS San Francisco. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)

One Comment

I just saw this story on the news and was stunned. Not because Ms. Jimno was ejected from Grant Cuesta, but because Grant Cuesta did the same thing first to my 84 yr. old roommate & next to me after knee replacement surgery at El Camino Hospital in Oct. 2010. I had to take a taxi home! Since I know EXACTLY now Ms. Jimno feels and what she is going through it is my plan to go visit her tomorrow at El Camino Hospital. Oh, and the state did NOTHING to help me. I hope Elizabeth puts it in her “tickler file” to follow up on Grant Cuesta and it’s future misdeeds because there’s something really wrong over there.

This is a shocking and tragic story of elder abuse. The elderly deserve to get the best care possible. Unfortunately, due to the lack of resources to deal with recalcitrant nursing homes, such cases are often ignored, There is a great need to provide alternate support for elderly–more in home care with caregivers helping out, That would lesson the financial strain on the state. I’m fortunate that my elderly mother gets private care in a residential setting. These places are licensed and if run properly, are a much better solution than nursing homes.

More of this is going to happen. California wants to roll back Medicare/Medical reimbursement to the 2009 levels, minus 1%. More skilled nursing facilities are going to close, pushing their residents out, away from their home areas, families and friends. The state of California should be ashamed, treating the elderly this way. How can they justify this?

Who is the “they” you are referring to? Do you mean “us” — the California taxpayers who don’t want to pay for those who would enforce the law? The taxpayers who don’t want to pay a higher rate to the nursing homes — or to set up state-run homes for the same purpose?

We need to abolish the two agency system and bring it all under one roof so that the agency that rules in the elderly’s favor is also empowered to enforce the law. If they closed down a few of these rogue nursing homes for violating the law instead of just fining them a $700.00 they can easily afford (since they charge residents upwards of $6-8,000 per month to be there) then they would all soon fall in line and start obeying the laws. I can not believe that with all of the taxes we pay and the money the State wastes that we are not doing more of this. This is clearly elder abuse and that is against the law!

The d*** state isn’t doing anything to help these people who are being dumped because the friggin nursing homes are money hungry. Why are they being allowed to treat recovering and/or elderly patients like day old garbage? Most of these people have nowhere else to go. It seems as though those that are supposed to follow up on these cases can’t be bothered because they will never have to go through this. They seem to feel that they have the money to pay for any care they might need, now or in the future.

I’m glad this story is getting exposure. My wife had her knees done and went to a post op place, such as this one. She will never have to do that again, because I won’t let it happen. These places need a “wake up call”, they must have a staffing problem, but that’s the least of their problems. While there, my needed help and no one came to check on her, or why she was calling for them. I was not there at the time, my wife called me on her cell phone, and I came right away. When I got there, not ten minutes later, there still had been no response to her call. Except for other patients, the place was empty of staff. I looked around and finally found someone who looked official, he was sitting watching TV. I told him my wife was paging them, his answer baffled me, when he said, oh they’ll get to her as soon as they can. I said who would that be? Begrudgingly he finally got up and said he would go find someone. I said you go do that. In the meantime, I found a wheelchair, pulled my car around, bundled up my wife, and took her home. Only when I got her into the car, did people come a running. They said you cant do that, I said watch me.
So if you need to go to one of these places……don’t

First of all, what they did was illegal because they have to hold her spot for 7 days, so that in itself makes it unacceptable. But even if it wasn’t illegal, there are established processes that nursing homes do use to kick residents out. This nursing home, and many others, choose not to follow those because they know there are few, if any, ramifications. Instead, they violate the due process rights of the residents and the laws of the state. If you would rather allow nursing homes to kick residents out willy nilly, then you should work on legislation to do that and hope that you or your loved ones never have to go to a nursing home.

During my teen years I worked as an aid in a Nursing Home. Bob M you were right to take your wife home. She got better care with you than at the home.
As an aid I had a unit of 10 elderly ladies to care for on my own. When I was taking one for a bath no one was there to watch over the other 9 women. The few real nurses at the desk were required to do paperwork and give out pills, leaving the aids to do the rest. During meals I would have 2 to hand feed while the others ate on their own. It was real hard and tiring work. I won’t ever do that again.
I felt that a couple of the ladies would have been better off with their families than in the nursing home warehouse.
I am very proud of my parents because they took in and cared for both of my grandfathers after their wives died rather than putting them in a nursing home. It was hard work but both men were well cared for and loved.

I have worked in the nursing home business for 20 years in upper management and have seen these trends more and more. It totally agree that the current system is horrible for the elderly. I agree with families that this growing problem is only going to get worse. And what the public fail to realize that the nursing home business is a GIANT profit making venture, especially if a patient has MEDICARE A insurance and not HMO. It’s so sad to see this happening. We definitely need some serious regulation on these matters. I SWEAR i have thought of writing a NOVEL on my 20 year experience working in nursing homes and share how up management-hospital administrators rob people and families.

Nursing homes do not want anyone that is a little harder to care for, ie, incontinence, screaming in pain, on Medi Cal This happened to my Mother at San Marco Nursing in Walnut Creek. It is disgusting the way Nursing home residents are treated!
Volunteer if you can.

As a CNA in a facility such as this I see it all the time. I went into this field because I wanted to be able to help the elderly, to give them the best time with what they had left. The joke has proved to be on me… I go to a job that I love, try to do the best I can for every one of my residents and yet I still get paid less than what I would working at McDonalds. Sad how much money is paid to help the elderly when no help is actually being given.

The Best of the Bay TV program is a “pay to play” — GC paid to have their placed showcased. I know this because my company got solicited by Best of the Bay. We turned them down. It’s just an advertisement in disguise, a fox in sheepskin.

Unfortunately the media tends to only portray negative stories and mistakes made in nursing homes. It is a shame. It is also unfortunate that Nursing Home management can’t share very much information and/or respond publicly to these types of allegations due to the Federal HIPAA Privacy Rule. Their silence is presumed to be an indication of guilt.
When you chose a nursing home, you want a safe environment for your loved one. You expect your loved one to be safe and protected. At times, very challenging patients, and their families make it difficult to balance maintaining regulatory compliance with the safety and welfare of the patients, BECAUSE THESE TWO THINGS DO NOT GO HAND IN HAND. When that happens, you should thank God if nursing home management is committed to doing the right thing to protect their patients. You won’t hear about those stories in the news, but if you did, you would have a much higher level of respect for the hard working nursing home employees and management. The elderly population is extremely susceptiible to various forms of abuse-both in and out of Nursing Homes- and one of the most vital responsibilites of nursing home management is to ensure that ALL residents are safe. Occassionallly that means a patient can not be re-admitted.

This is a truth twisting at its worst. HIPAA does not prohibit Nursing Homes from speaking the truth. They can’t speak about a particular patient’s medical history, but they can certainly speak to the policies here that are clearly illegal. If they did not and do not engage in these practices, they are free to respond. Excuses based in truth twisting do not help any of us get to the truth or address the horrible things that are happening, no matter whose fault they are. If you want to present a different perspective, please do, it would enhance the conversation here, but please do so honestly.

The true story is how “The Department of Public Health”, the regulating agency in this case having jurisdiction is failing our vulnerable citizens. We the tax payer now fund four times the employee’s within the California’s Department of Public Health since the terminator took office; only to hear the same lame excuses, “we are under staffed”, “these are hard economic times” and “we have to be careful not to upset the provider”…. Yet the profits are unbelievable.

The interviewed, Department of Public Health representative stated the department did their job… this is factually misleading. DHS only took the first steps. The department has many additional tools at their disposal. Lets be clear… the state could start the process to stop the funding via Medical, Medicaid and Medicare. Once our taxpayer’s monies STOP – I guarantee, management within these skilled nursing homes would quickly become compliant with the law. Let our money do the talking.

Additionally, the state just released a report this week, admitting to the failures within “The Department of Public Health” – Look it up for yourself, read it, it’s a 26 page report – “An Independent Review of the California Department of Public Health” authored by Lynette Iwafuchi, CPA – Spring 2011.
Additionally, the Department of Public Health has decided to impose a new
‘POLICY‘ to not act as the enforcement agency, but rather to take on an advisory role – clearly against the departments legal mandate and mission statements.

The Daly City District field Office (CDPH) goes as far to limit citations to patient rights violations – citing state regulations that have “NO” teeth. Avoiding the more costly and restrictive civil codes/laws within United States Codes -USC, Code of Federal Regulations – CFR, California Code of Regulations – CCR, Code of California Health and Safety Code – H&S and the California Welfare & Institutions Code – to help limit the skilled nursing homes exposure to litigation and minimizes fines that are reported on state form 6899. The fines are usually issued well below the required minimums posted on the CDPH official web site, further protecting these nursing homes. During these hard economic times, why are fines rarely collected? The large national skilled nursing homes – lawyer up and intimidate state employee’s making them afraid to ruffle any feathers. The Department of Public Health supervisors and DHS Management actively cover up many real violations and/or abuses. Effectively, allowing the state to act as the risk management department for these large nursing home providers.

By not enforcing the MINIMUM REQUIREMENTS MANDATED BY LAW – “The Department of Public Health” using simple deductive reasoning is an ACTIVE PARTICIPANT in Elder Abuse and Medical, Medicaid and Medicare FRAUD. Where is the accountability? Who is in charge? This is the fox watching the hen house.

Ask yourself if you were the one living in one of these beds, and had no where else to go, would you want to live below the minimum standard required by law?

Why are there all these civil laws to protect dogs, cats or other animals from abuse, yet NO similar civil laws or codes exist to protect our seniors from the same level of abuse! One simple word explains why – LOBBIST.

Our nations truest National Treasure is represented by our seniors representing OUR PAST AND by our children representing – OUR FUTURES. The seniors rarely have a strong voice. Where are they going to get the monies for an attorney to get proper protection from these nursing homes that dump them to the curb? Where do they go in the mean time? Get involved; make a difference, demand our elected officials to do something to strengthen the law. Because doing nothing is just not acceptable. What is the chance in the next ten, fifteen years this could be you getting dump!

Why we let these crooks treat people this way is wrong.The funding needs to be suspended,pass laws needed to stop this,enforce those laws,and put the ones responsible for not following them to the “T” behind bars.These people make way too much money not to be held accountable,fined and or jailed!

Get rid of Kathleen Billingsley and the rest of the folks working for the Department of Public Health who care more about pleasing the providers than the patients. Senator Alquist and Secretary Dooley, are you listening?

Secretary Dooley requested an audit into the Department of Public Health and the report of that audit was posted on the CHHS website: http://www.chhs.ca.gov
It does not appear on the DPH website, and for good reason. The report does not paint a very pretty picture of the characters who are highly paid to make sound policies and ENFORCE the laws that protect patients in nursing homes. DPH is to blame for the abuse in these homes — they are the enforcement agency and are clearly not doing their job. Secretary Dooley, please do your part and get rid of these obvious incompetent people asap.

Why is the “California Department of Public Health” not doing their job as mandated by legal statue? All employees within the “California Department of Public Health” have sworn an oath to uphold ALL state and federal laws. Clearly CDPH senior management has drawn a line in the sand. On one side the large corporate providers, with there high priced attorneys representing the nursing home industry and on the other side are the disenfranchised Californian’s, including the vulnerable seniors as represented in the ABC Channel 5 segment entitled “California Nursing Home Evictions on the Rise”.

Question: Who is in the power seat—CA citizens and residents or the entity with all the money? The nursing home industry of course! Including Corp providers (out of state) and high priced lobbyists, based in Sacramento who boast about their ready access to duly sworn officers or chiefs within the highest levels of CDPH. NO APPOINTMENT NECESSARY – for ‘select stakeholders’ the doors are always open to these preferred providers or their attorneys and/or lobbyists located right down the street in Sacramento. Once high priced Corp attorneys and lobbyist, are able to get their foot in the door – these powerful entities are allowed to directly influence regulation of their industry, oversight, and if or when any enforcement actions are taken— such as the citation and appeal process mentioned in this segment. These groups and entities have too much influence in the overall process; working together with CDPH behind closed door to ultimately under mine the letter of the law and violate a patient’s right to return to their home and friends.

The question everyone wants answered; what authority or statute has the “California Department of Public Health” relied on to avoid enforcing ALJ judgments and citations?

STOP MAKING EXCUSES AND JUST DO YOUR JOB. STOP looking for any singular word or phrase to twist or mislead to the desired out come. As represented by Al Lundeen, the CDPH representative during the CBS interview, who craftily worded his response to mislead Californians when he stated, “Ultimately if they are not abiding by the law we have the ability to issue citations,” Read between the lines here, does the CDPH not always issue citations when the law is broken? Humm! But they do have the ability to issue citations, WOW! Lundeen insists his Department is doing everything it can under the law. This is simple department double speak. This is like the classic Abbott and Costello baseball skit “Who’s on first?” What if the CHP acted the same way, we would have chaos on the highways.

The CDPH’s mandate is simple, to ENFORCE the MINIMUM REQUIREMENTS required by law, nothing less is acceptable – anything below the minimum requirements is a crime. Its time to hold this department liable for the millions of dollars spent with little to NO ACCOUNTABLITY! The entire department is ineffective and needs to be dissolved.

THE CALIFORNIA GOVERNOR, CALIFORNIA STATE ATTORNEY GENERAL, SECRETARY OF HEALTH AND HUMAN SERVICES AND THE US AND THE CALIFORNIA DEPARTMENT OF JUSTICE ALL NEED TO TAKE LONG HARD LOOK INTO THE ILLEGAL ACTIONS TAKEN BY THE DEPARTMENT OF PUBLIC HEALTH. THOSE FOUND TO HAVE VIOLATED THE LAW WITH MALIOUS INTENT SHOULD GO DIRECTLY TO JAIL!